Speaker Requests - HR Works

Name of Organization Submitting Request(Required)

Contact Name(Required)

First Last

Contact Phone(Required)

Contact Email(Required)

Event Name/Title

Event Date

Event Time

# of Participants Expected

Event Type

Event Location (if in person)

Street Address City State / Province / Region ZIP / Postal Code

Event Website

If applicable

Format

(conference session, roundtable, panel, etc.)

Expected Duration

Topic(s) of Interest(Required)

SHRM / HRCI Credits

Deadline of Acceptance

Please indicate when your deadline for accepting commitments is.

Offer of Payment/Reimbursement:

(none, flat fee, dining, lodging, travel, etc.)

Additional Details / Message

Please provide any other information you think would be helpful, as well as any desired topics not listed in the options provided.